Patients turning to private healthcare to beat NHS cuts

Patients are increasingly being driven to pay for private healthcare because of tough restrictions being placed on GP referrals and cuts in the availability of some procedures on the NHS.

Three major private healthcare companies approached by Pulse reported a surge in the number of ‘self-pay’ procedures, as patients who do not have medical insurance nevertheless choose to go private to avoid blocks placed on GP referrals.

Spire Healthcare, which runs 37 private hospitals across the UK, saw a 10% year-on-year increase in the number of self-pay ‘clinically necessary procedures’ it carried out in October.

The number of enquiries it received about self-pay procedures also increased sharply, by 33%, between August and November.

Nuffield Health, which has 30 private hospitals, also recorded an increase in self-pay treatments this year, particularly for two areas that have been the subject of stringent referral management and rationing – orthopaedics and plastic surgery.

And BMI Healthcare, which describes itself as ‘Britain’s leading provider of independent healthcare’ said it has seen a ‘continued and steady’ increase in the number of self-pay procedures.

The rises have prompted concerns from GP leaders that increasing use of referral management centres and other referral restrictions, coupled with rationing of ‘low clinical priority’ procedures, is undermining the NHS.

They come as Pulse’s A right to refer campaign demands a secretary of state guarantee of GPs’ right to refer, and calls for clinical commissioning groups to put all referral management centres to a ballot of practices.

Dr Jean-Jacques de Gorter, clinical services director at Spire Healthcare, said: ‘The increase in enquiries about private treatment is largely the result of changes we’re seeing in the UK healthcare system. NHS funding can only stretch so far.’

A Spire survey of 1,000 GPs found 32% expected to make more referrals to private hospitals in 2012 than in 2011, with just 5% expecting to make fewer.

A spokesperson for Nuffield Health said: ‘We can see a trend that self-pay has gone up. They key areas are plastics and orthopaedics.’

Dr Clare Gerada, chair of the Royal College of GPs, warned there was a risk patients would increasingly see the NHS as providing ‘sub-optimum’ healthcare: ‘GPs are being restricted in what and who they can refer, you have referral management systems putting barriers between the GP, patient and specialist, a limited budget for commissioning and the squeeze in hospitals. If people want to go privately that’s fine, but I don’t want a health service that is sub-optimum compared with what you can get privately.’

Richard Hoey, editor of Pulse, said: ‘GPs are reporting restrictions in access to a whole range of treatments, from hip and knee replacements to IVF, and their referrals are being routinely screened in many places, which injects delays and uncertainty into the process. It’s maybe not surprising that these developments appear to be undermining faith in the NHS, and that increasing numbers of uninsured patients are choosing to pay to have procedures done privately rather than wait to see if the NHS can find the cash. But we must remember – the more people who can afford it go privately, the less willing they are likely to be to pay towards a national healthcare system that everyone can access.’